Analysis Scores GSK, J&J High on Antibiotic Development Efforts

These and other companies are taking steps to fight antimicrobial resistance

An independent analysis of pharmaceutical industry efforts to tackle drug resistance gives high marks to GlaxoSmithKline and Johnson & Johnson among the large research-based pharmaceutical companies, while Mylan leads the generic medicine manufacturers and Entasis leads in the biotechnology group.

The Antimicrobial Resistance Benchmark 2018, published by the Netherlands-based Access to Medicine Foundation, finds that companies are also dismantling incentives that encourage sales staff to oversell antibiotics, setting limits on the concentration of antibiotics in factory wastewater, and tracking the spread of superbugs. But it finds room for all companies to improve. 

"If we don't use antibiotics in the right doses or for the right bugs, we risk giving bacteria a chance to adapt and strengthen their defenses, which will make it harder to kill them the next time," said Jayasree K. Iyer, Executive Director of the Access to Medicine Foundation. "Pharmaceutical companies have a critical contribution to make to the effort to tackle superbugs."

Antibiotics are losing their effectiveness at an increasing rate, accelerated mostly by their misuse in humans, animals, and crops.. There is now wide recognition that more needs to be done urgently to slow the pace of antimicrobial resistance (AMR).

The benchmark compares how a cross-section of the pharmaceutical industry is responding to the threat. It measures the 30 most active players in antimicrobial development and production and includes multinational pharmaceutical companies, biotechnology firms, and manufacturers of generic medicines. The main areas tracked are: research and development (R&D) for new antimicrobials, policies for ensuring antibiotics are manufactured responsibly, and approaches to ensure antimicrobials are accessible and used wisely.

GSK and Johnson & Johnson lead the eight large research-based pharmaceutical companies included in the benchmark. GSK has the most antimicrobial medicines in its R&D pipeline, including for pathogens experts view as the highest priority targets for AMR. GSK is one of only two companies to fully separate bonuses from the volume of antibiotic sales, removing the incentive for sales staff to oversell antibiotics.

Johnson & Johnson focuses its attention on tuberculosis (TB): access to its breakthrough medicine for multidrug-resistant TB is being tightly controlled through national TB programs. These leaders are followed by Novartis, Pfizer, and Sanofi together. Pfizer performs particularly well in stewardship measures, while Sanofi is stronger in R&D. Novartis' delivers a consistently solid performance in most areas. 

Biotechnology firms have a critical role to play in developing new antimicrobials. Among the 12 the benchmark covers, Entasis leads, particularly when it comes to planning ahead to help ensure successful candidates will be made accessible but also used wisely. It is followed by Polyphor, Summit, and Tetraphase in joint second place.

Generics manufacturers account for the majority of antibiotics sold today, giving them significant power to slow the growth of AMR. The leaders in this group show a more defined response than that of their peers, addressing either affordability or the rational use of their products. Of the 10 evaluated, Mylan has the strongest performance in several areas, including an equitable pricing approach and environmental risk-management strategy. It is followed by Cipla, then Fresenius Kabi.

The benchmark's key findings include: 

  • There are 28 antibiotics in later stages of development that target the pathogens deemed critical AMR priorities, but only two of these 28 are supported by plans to ensure they can be both made accessible and used wisely if they reach the market.
  • Nearly half of companies evaluated are involved in efforts to track patterns in drug resistance. Pneumonia is the most widely tracked infection. Pfizer is running the most programs.
  • Eight companies are setting limits on the concentration of antibiotics that manufacturing wastewaters can contain before they can be released into the environment. Four companies require suppliers to also meet these standards: GSK, Johnson & Johnson, Pfizer, and Roche.
  • Four companies are taking steps to separate sales agent's bonuses from the volume of antibiotics they sell. GSK and Shionogi have fully separated the two globally, Pfizer is piloting that approach in certain locations, and Novartis is in the process of adjusting the incentives for its sales teams.

Source: Access to Medicine Foundation; January 23, 2018.